DESCRIPTION: (Applicant's Description) Cigarette smoking remains the single most preventable cause of mortality and morbidity in this country. Despite decades of smoking prevention and cessation efforts, approximately 25% of adults smoke (USDHHS, 1990). Undoubtedly, this is partially due to the fact that smoking is highly addictive and most smoking cessation efforts fail (USDHHS, 1988). Given the highly refractory nature of smoking, much attention has been directed at preventing adolescent smoking. Indeed, it has been concluded that if smoking can be delayed to age 18, the vast majority of adult smoking can be prevented (USDHHS, 1994). Despite the large number of smoking prevention programs that have been developed and validated, there have been few controlled studies of smoking cessation interventions in youth (Lotecka & MacWhinney, 1983; Perry et al., 1980) and none have assessed the effectiveness beyond the treatment phase using biochemical verification of smoking status Burton, 1994; Klesges, 1996). Moreover, recruitment of subjects has been extremely difficult (USDHHS, 1994). There is a strong need to develop adolescent smoking cessation programs, as the number of high school students who are regularly smoking is now nationally 34.9% (CDC, 1996), a rate that has been growing in recent years and which now exceeds that of the adult population. While national data are not available, an extremely common school violation is smoking in the school setting. Typically, the parents arc notified and the student is given some type of in-school or out-of-school suspension. This revision of a project submitted in response to RFA CA-97-010 seeks to utilize a unique opportunity to validate and then evaluate a smoking cessation program in underserved adolescent smokers in a randomized, controlled fashion. Our long standing excellent relationship with the local school systems allow us to propose what we believe is the first controlled, large scale smoking cessation program with a high degree of disseminability. Thus, we propose the following specific aims: (1) To recruit and randomize approximately 1250 children who have been caught smoking against school rules to either standard sanctions (3 day suspension) or to a six session, four week smoking cessation program; (2) To evaluate the long-term (one year) efficacy of this intervention using biochemically verified smoking cessation rates.